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Episode 079: Health Care Price Transparency without an Executive Order with Dr. Bill Hennessey of Pratter

The Paradocs Podcast with Eric Larson

Release Date: 02/20/2020

Episode 154: Rethinking Vaccine Mandates and the Omicron Variant with Dr. Monica Gandhi show art Episode 154: Rethinking Vaccine Mandates and the Omicron Variant with Dr. Monica Gandhi

The Paradocs Podcast with Eric Larson

  Vaccine mandates, mask mandates, boosters, and variants have been a constant source of debate and controversy with the pandemic. My guest today is Dr. Monica Gandhi, an expert in immunology and infectious disease who runs the HIV clinic at UCSF. She has been a fairly prominent voice in support of the mask and vaccine mandates in her home state of California and city of San Francisco. She returns from her visit in June for SARS-CoV-2 in which she guessed that it wouldn't evade the vaccine or prior infection (spoiler alert: she was right). Do Vaccine Mandates Make Sense? Dr. Gandhi is...

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Episode 153: Crowd Health is Go Fund Me for Health Care on Nitro with CEO Andy Schoonover show art Episode 153: Crowd Health is Go Fund Me for Health Care on Nitro with CEO Andy Schoonover

The Paradocs Podcast with Eric Larson

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Episode 152: The COVID Drawdown show art Episode 152: The COVID Drawdown

The Paradocs Podcast with Eric Larson

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Episode 151: Health Care for Those Who Don't Earn High Wages with Dr. David Berg show art Episode 151: Health Care for Those Who Don't Earn High Wages with Dr. David Berg

The Paradocs Podcast with Eric Larson

  One of the scariest times for many workers is being presented with a bill for medical services. Even if they have insurance "coverage", the deductible or co-pay might be more than they can afford. For hourly workers in entry level jobs or low skilled positions, medical bankruptcy is a real fear. While barely making ends meet an additional bill for an ER visit or doctor's office stop can send you to collections and destroy your credit. Unfortunately, a lot of Americans are in this exact spot as they earn a living working these low paying jobs but have little medical security even if...

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Episode 150: Make Sure Your Health Insurance Broker is Working for You and not the Insurance Company with David Contorno. show art Episode 150: Make Sure Your Health Insurance Broker is Working for You and not the Insurance Company with David Contorno.

The Paradocs Podcast with Eric Larson

When you run a business, one person you usually meet and hire is a health insurance broker. In theory, these brokers work with the employers to secure the best deals for health insurance to meet the company's health care objectives. However, in practice, the brokers serve as a sales force for the insurance companies who lavish them with bonuses, trips, and gifts. The seedy underbelly of the health insurance broker industry is that they are really not working to save money or get deals for their clients - the checks are written by the insurance carriers and that's who they answer to. Who do...

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Episode 149: Is Asymptomatic Spread of SARS-CoV-2 a Thing? with Daniel Halperin, PhD show art Episode 149: Is Asymptomatic Spread of SARS-CoV-2 a Thing? with Daniel Halperin, PhD

The Paradocs Podcast with Eric Larson

  Not only has the COVID pandemic politicized our country - it has led to a lot of misinformation and a shutdown of communication. For instance, is there really asymptomatic spread of COVID? Or just pre-symptomatic and symptomatic spread? That might seem like splitting hairs but it can have a profound effect on policy for quarantining and testing. We've talked about this before on the show as well as general discussions on COVID policy which can be found , , and . 12 Myths and 12 Facts About COVID-19 If there is one certainty during this confusing pandemic it is that there are plenty of...

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The Paradocs Podcast with Eric Larson

  There are a lot of urgent care clinics all over the country. But few of them, to my knowledge, also operate as regular primary care clinics. But that is exactly what is happening today in the Houston, Texas area with the emergence of Next Level Medical. If you think about it, it makes perfect sense to leverage all the facilities needed for a primary care clinic - exam rooms, physicians, etc. and use it to deliver regular and sometimes non-urgent care. We've discussed before that lower the cost of care with transparency so this seems like the next logical step with urgent care. We...

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Episode 147: Has the Pandemic Led to Infants Losing IQ? - with Sean Deoni, PhD show art Episode 147: Has the Pandemic Led to Infants Losing IQ? - with Sean Deoni, PhD

The Paradocs Podcast with Eric Larson

  The COVID pandemic has brought on all sorts of changes to the way we live our lives. From wearing masks, working from home, stay at home orders, and restrictions on social interactions, the virus has caused untold disruption to the way our society functions. Although the changes COVID has brought to our schools and the lives of our school age children, it is perhaps less appreciated what changes have occurred for our infants. It is a well known fact that our environment and meaningful stimulation is necessary for normal intelligence and brain development. Infants are completely...

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Episode 146: Explaining COVID in 11 Minutes with Dr. Eric Larson show art Episode 146: Explaining COVID in 11 Minutes with Dr. Eric Larson

The Paradocs Podcast with Eric Larson

  Imagine yourself in California at a clearing in a large forest. And it’s on fire. There are three groups of people standing before you. A large group is screaming and running around pointing at the fire. They’re yelling that we need to do something, anything we can to stop the fire. Meanwhile, there is another group (not as large) with their backs to the fire. They are mocking and ridiculing the group running around panicking. They tell them to calm down and to stop ordering people around. They insist there isn’t anything wrong at all. Of course, the largest group of people are...

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Episode 145: Surgery without Insurance with Dr. Keith Smith show art Episode 145: Surgery without Insurance with Dr. Keith Smith

The Paradocs Podcast with Eric Larson

  A lot has happened since we last met with Dr. Keith Smith from the back in 2018. . We also spoke about how the system was rigged to enrich the hospital systems, insurance carriers, and PBMs (what's new right?). So what's happened since then and how has the center done with the pandemic? Is the Surgery Center of Oklahoma Thriving or Just Surviving? Not surprisingly, Dr. Smith says that the center is doing just fine and has increased its market share from other states. Additionally, the international community from Canada is now being allowed to come back into the US for their...

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Real health care price transparency is a an elusive goal for many in the medical community.  Whether it is employers or individuals there is a real demand for people to want to know the prices of care before it is delivered. It might be imaging or common surgical procedures or laboratory work but ultimately, very few know how much their bills will be when they arrive a few months later. This lack of price transparency makes it difficult to be a conscientious consumer and drives people crazy.

That's where my guest today comes in, Dr. Bill Hennessey. Dr. Hennessey is the CEO of Pratter which is a medical consulting company that helps self insured companies/groups find affordable care. By using millions of claims in their database with government and commercial payers they provide their clients easy to understand reports on ways to save on their employees or member's medical care. This is accomplished mainly by redirecting people to lower cost options for imaging, surgery, and laboratory testing.

The main focus so far for the company has been to self insured employers and unions but Dr. Hennessey expects to launch a direct to consumer product of Pratter either later this year or early 2021. This release of prices for easily comparable services will revolutionize the health care market and disrupt the current system of multiple contracting with insurance carriers. I suspect even before the presidential executive order makes its way out of the courts it will already be moot as the market has shifted towards greater transparency from market pressure.

One example mentioned by Dr. Hennessey of the craziness of pricing is for inguinal hernia repairs by payer and location.

  • Medicare for in hospital outpatient is $2783.
  • Medicare for free standing surgical center is $2487
  • Avg. Commercial payer for free standing surgical center is $2586
  • Avg. Commercial payer for hospital outpatient is $5869! Dr. Bill Hennessey is a PM&R physician by training and the CEO of Pratter, Inc.
show notes

Pratter, Inc.

Pratter on LinkedIn

Health Care consumer tips: This is the link to the tip page with ways consumers can protect themselves from outrageous hospital bills. The first tip is be aware before you get care.

Episode 002: My discussion with Dr. Belen Amat on why she chose direct primary care. This is an example of the types of ways of saving on health care given by Dr. Hennessey.

Made Simply Web Site Creations: This is the great, affordable website service that built my wife's podcast site. I cannot recommend this company more to someone looking for creating a website.

Always Andy's Mom: Home of my wife, Marcy's, podcast for parents grieving or those looking to help them.

YouTube for Paradocs: Here you can watch the video of my late son singing his solo on the Paradocs YouTube page.

Patreon - Become a show supporter today and visit my Patreon page for extra bonus material. Every dollar raised goes towards the production and promotion of the show.

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